scholarly journals Examining the Effect of General Practitioner Practice Size on Prescribing Behaviours in Northern Ireland

2020 ◽  
Author(s):  
Frederick G. Booth ◽  
Maurice Mulvenna ◽  
Raymond Bond ◽  
Kieran McGlade ◽  
Debbie Rankin ◽  
...  
Keyword(s):  
General Practitioner ◽  
Northern Ireland ◽  
General Practitioner Practice ◽  
Practice Size

Patient preferences for specialist outpatient video consultations: A discrete choice experiment

2021 ◽  
pp. 1357633X2110228
Author(s):  
Centaine L Snoswell ◽  
Anthony C Smith ◽  
Matthew Page ◽  
Liam J Caffery
Keyword(s):  
General Practitioner ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Healthcare Delivery ◽  
General Practitioner Practice ◽  
Specialist Care ◽  
Time Away ◽  
Out Of Pocket Costs

Introduction Telehealth has been shown to improve access to care, reduce personal expenses and reduce the need for travel. Despite these benefits, patients may be less inclined to seek a telehealth service, if they consider it inferior to an in-person encounter. The aims of this study were to identify patient preferences for attributes of a healthcare service and to quantify the value of these attributes. Methods We surveyed patients who had taken an outpatient telehealth consult in the previous year using a survey that included a discrete choice experiment. We investigated patient preferences for attributes of healthcare delivery and their willingness to pay for out-of-pocket costs. Results Patients ( n = 62) preferred to have a consultation, regardless of type, than no consultation at all. Patients preferred healthcare services with lower out-of-pocket costs, higher levels of perceived benefit and less time away from usual activities ( p < 0.008). Most patients preferred specialist care over in-person general practitioner care. Their order of preference to obtain specialist care was a videoconsultation into the patient’s local general practitioner practice or hospital ( p < 0.003), a videoconsultation into the home, and finally travelling for in-person appointment. Patients were willing to pay out-of-pocket costs for attributes they valued: to be seen by a specialist over videoconference ($129) and to reduce time away from usual activities ($160). Conclusion Patients value specialist care, lower out-of-pocket costs and less time away from usual activities. Telehealth is more likely than in-person care to cater to these preferences in many instances.

Treating body, treating mind: The experiences of people with psychotic disorders and their general practitioners – Findings from the Australian National Survey of High Impact Psychosis

2017 ◽  
Vol 52 (6) ◽  
pp. 561-572 ◽  
Author(s):  
Anna Waterreus ◽  
Vera A Morgan
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Practitioner ◽  
Mental Health Services ◽  
Health Services ◽  
General Practitioners ◽  
Psychotic Disorders ◽  
Phase 1 ◽  
General Practitioner Practice ◽  
Physical And Mental Health

Objectives: To describe from the perspective of people living with psychotic illness their use of general practitioner services over a 12-month period and the experiences, attitudes and challenges general practitioners face providing health care to this population. Methods: A two-phase design was used. Phase 1, screening for psychosis, occurred in public specialised mental health services and non-government organisations within seven catchment sites across Australia. In Phase 2, 1825 people who were screened positive for psychosis were randomly selected for interview which included questions about frequency and reason for general practitioner contact in the 12 months prior to interview. General practitioners (1473) of consenting participants were also surveyed. Results: Almost all (90.3%) survey participants had consulted a general practitioner in the 12-month period, on average 8.9 times, and 28.8% of attenders had consulted 12 times or more. The majority (83.5%) attended one general practitioner practice. Most (77.6%) general practitioners wanted to be involved in the mental health care of their patient. Although 69.1% said the management of their patient was not problematic for their practice, one in five general practitioners reported issues related to patient non-compliance with treatment and non-attendance at scheduled appointments; time constraints; and lack of feedback from treating mental health services. Conclusion: People with psychotic disorders consult general practitioners, some very frequently. Most Australian general practitioners believe they have a responsibility to review the physical and mental health of their patients. Improved communication between general practitioners and mental health services, and easier access to mental health support, may help general practitioners manage the complex mental, physical and social problems of their patients.

scholarly journals Trends in generalised anxiety disorders and symptoms in primary care: UK population-based cohort study

2020 ◽  
pp. 1-7
Author(s):  
April Slee ◽  
Irwin Nazareth ◽  
Nick Freemantle ◽  
Laura Horsfall
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Temporal Trends ◽  
Population Based ◽  
Incidence Rates ◽  
Anxiety And Depression ◽  
General Practitioner Practice ◽  
Health Improvement ◽  
Mixed Regression ◽  
Pharmacologic Treatments

Background Generalised anxiety disorder and symptoms are associated with poor physical, emotional and social functioning and frequent primary and acute care visits. We investigated recent temporal trends in anxiety and related mental illness in UK general practice. Aims The aims of this analysis are to examine temporal changes in recording of generalised anxiety in primary care and initial pharmacologic treatments. Method Annual incidence rates of generalised anxiety diagnoses and symptoms were calculated from 795 UK general practices contributing to The Health Improvement Network (THIN) database between 1998 and 2018. Poisson mixed regression was used to account for age, gender and general practitioner practice. Subsequent pharmacologic treatment was examined. Results Generalised anxiety recording rates increased in both genders aged 18–24 between 2014 and 2018. For women, the increase was from 17.06 to 23.33/1000 person years at risk (PYAR); for men, 8.59 to 11.65/1000 PYAR. Increases persisted for a composite of anxiety and depression (49.74 to 57.81/1000 PYAR for women; 25.41 to 31.45/1000 PYAR for men). Smaller increases in anxiety were seen in both genders age 25–34 and 35–44. Anxiety rates among older patients remained stable, although a composite of anxiety and depression decreased for older women. About half of drug-naïve patients were prescribed anxiety drugs within 1 year following diagnosis. The most common choice was a selective serotonin reuptake inhibitor. Benzodiazepine prescription rate has fallen steadily. Conclusions We observed a substantial increase in general practitioner consulting for generalised anxiety and depression recently, concentrated within younger people and in particular women.

scholarly journals Delayed attendance at routine eye examinations is associated with increased probability of general practitioner referral: a record linkage study in Northern Ireland

2020 ◽  
Vol 40 (3) ◽  
pp. 365-375 ◽  
Author(s):  
David M Wright ◽  
Dermot O'Reilly ◽  
Augusto Azuara‐Blanco ◽  
Raymond Curran ◽  
Margaret McMullan ◽  
...  
Keyword(s):  
General Practitioner ◽  
Northern Ireland ◽  
Record Linkage ◽  
Linkage Study

scholarly journals HEMATURIA IN GENERAL PRACTITIONER PRACTICE

2020 ◽  
Vol 18 (2) ◽  
pp. 187-192
Author(s):  
Y. I. Karpovich ◽  
◽  
V. M. Pyrochkin ◽  
V. A. Snezhitskiy ◽  
N. A. Nechiporenko ◽  
...  
Keyword(s):  
General Practitioner ◽  
General Practitioner Practice

scholarly journals Discovering and comparing types of general practitioner practices using geolocational features and prescribing behaviours by means of K-means clustering

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Frederick G. Booth ◽  
Raymond R Bond ◽  
Maurice D Mulvenna ◽  
Brian Cleland ◽  
Kieran McGlade ◽  
...  
Keyword(s):  
General Practitioner ◽  
Rural Areas ◽  
Prescribing Patterns ◽  
Prescription Data ◽  
National Formulary ◽  
Practice Size ◽  
Different Types ◽  
Size Population ◽  
Prescription Rates ◽  
The Difference

AbstractTraditionally General Practitioner (GP) practices have been labelled as being in Rural, Urban or Semi-Rural areas with no statistical method of identifying which practices fall into each category. The main aim of this study is to investigate whether location and other characteristics can provide a tautology to identify different types of GP practice and compare the prescribing behaviours associated with the different practice types. To achieve this monthly open source prescription data were analysed by practice considering location, practice size, population density and deprivation rankings. One year’s data was subjected to k-means clustering with the results showing that only two different types of GP practice can be classified that are dependent on location characteristics in Northern Ireland. Traditional labels did not describe the two classifications fully and new classifications of Metropolitan and Non-Metropolitan were used. Whilst prescribing patterns were generally similar, it was found that Metropolitan practices generally had higher prescribing rates than Non-Metropolitan practices. Examining prescribing behaviours in accordance with British National Formulary (BNF) categories (known as chapters) showed that Chapter 4 (Central Nervous System) was responsible for most of the difference in prescribing levels. Within Chapter 4 higher prescribing levels were attributable to Analgesic and Antidepressant prescribing. The clusters were finally examined regarding the level of deprivation experienced in the area in which the practice was located. This showed that the Metropolitan cluster, having higher prescription rates, also had a higher proportion of practices located in highly deprived areas making deprivation a contributing factor.

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